Migrated Avalon Veno‐Venous Extracorporeal Membrane Oxygenation Cannula: How to Adjust Without Interruption of Flow. Issue 11 (11th September 2015)

• Record Type: Journal Article
• Authors: Tanaka, Daizo; Pitcher, Harrison T.; Cavarocchi, Nicholas; Hirose, Hitoshi
• Is Part Of: Journal of cardiac surgery. Volume 30:Issue 11(2015:Nov.)
• Page Start: 865
• Page End: 868
• Publication Date: 2015-09-11
• Subjects: Heart -- Surgery -- Periodicals; 617.412005
• DOI: 10.1111/jocs.12629
• Languages: English
• ISSNs: 0886-0440

Abstract

ABSTRACT : The Avalon dual lumen cannula is presently the cannula of choice for veno‐venous extracorporeal membrane oxygenation (VV‐ECMO) via right internal jugular cannulation. This cannula establishes VV‐ECMO with a single cannulation; however, it requires appropriate positioning to gain adequate oxygenation. Malposition of this cannula can cause inadequate ECMO flow, hypoxia, and structural injury. We have experienced two cases of migration: one into the hepatic vein and the other into the right ventricle. The former was repositioned using echocardiographic guidance without using a guidewire. The latter was repositioned using a guidewire from the femoral vein under fluoroscopy, without antegrade wire placement into the Avalon cannula, discontinuation of ECMO, or bleeding.